Automated pharmacy system for dispensing unit doses of pharmaceuticals and the like

RELATED APPLICATIONS

The present application is a continuation of U.S. patent application Ser. No. 14/281,301, filed May 19, 2014, which is a continuation of U.S. patent application Ser. No. 13/181,873, filed Jul. 13, 2011, which claims priority from U.S. Provisional Patent Application No. 61/364,038, filed Jul. 14, 2010; 61/394,828, filed Oct. 20, 2010; and 61/424,161, filed Dec. 17, 2010, the disclosure of each of which is hereby incorporated herein in its entirety.

FIELD OF THE INVENTION

The present invention relates generally to dispensing machines, and more particularly to dispensing machines for pharmaceuticals.

BACKGROUND OF THE INVENTION

Long-term care medical facility settings include assisted living facilities, skilled nursing facilities, group homes, etc. Assisted living and skilled nursing facilities typically have medical staff that are responsible at all times for and oversee the administration of medication to the patients/residents of the facility, as prescribed by the physician or otherwise needed. Group homes may or may not have live-in or around-the-clock staff that are responsible for all medication administration to the residents; such staff may be available only on a periodic basis (e.g., only during the day time, one or more times per week, etc.) in which case the residents may be responsible for their own medication the majority of the time. Such long-term care facilities are increasingly being asked to handle more and more of the medication storage responsibility that once rested almost totally with the community pharmacy. Long-term care pharmacy providers are typically not located within the actual patient facility; in fact, it is not uncommon for the pharmacy to be several hundred miles away. With new patient admissions occurring at unpredictable time throughout the day and existing patients' medical regimens changing without notice, it is imperative for those facilities without a physical pharmacy on site or access to one in a timely manner, to have non-patient specific medications on site for facility administration to the patients. Historically, facilities have stored medications in various types of non-mechanized containers and tracked drug product additions and removals with manual logs. Mechanized systems have primarily been limited to storage cabinets with a variety of drawers that house specific medications in predetermined locations. The drawer systems typically have secure access features which limit access to authorized users, typically facility staff that have the appropriate credentials, passcode, security pass, etc. to enable unlocking of a drawer to allow access to that user; however, once a user opens a drawer, there are only limited safeguards to prevent the wrong quantity or wrong drug from being removed, as this is a manual selection and removal process by the system user.

In view of the foregoing, it may be desirable to provide improved systems for dispensing medications for patients in long-term care facilities and other medical environments.

SUMMARY OF THE INVENTION

As a first aspect, embodiments of the present invention are directed to a system for storing and dispensing discrete doses of pharmaceuticals. The system comprises: a housing with an internal cavity having a front wall with first and second windows; multiple storage locations positioned within the housing; and a carrier assembly positioned and movable within the housing. The carrier assembly is configured to receive a pharmaceutical dose package loaded into either the first or second window and convey the pharmaceutical dose package to one of the storage locations for storage therein, and is further configured to retrieve a pharmaceutical dose package from one of the storage locations and return the pharmaceutical dose package to the first or second window for dispensing therefrom.

As a second aspect, embodiments of the present invention are directed to a system for storing and dispensing discrete doses of pharmaceuticals, comprising: a housing with an internal cavity having a front wall with a window; multiple storage locations positioned within the housing; a carrier assembly positioned and movable within the housing; and a plurality of bins, each of the bins configured to reside in one of the storage locations. The carrier assembly is configured to receive a bin that contains a pharmaceutical dose package loaded into the window and convey the bin and pharmaceutical dose package to one of the storage locations for storage therein, and is further configured to retrieve a bin that contains a pharmaceutical dose package from one of the storage locations and convey the bin and pharmaceutical dose package to the window for dispensing therefrom.

As a third aspect, embodiments of the present invention are directed to a carrier assembly for a storage and dispensing apparatus, comprising: a base; a pair of jaws, the jaws having facing contact surfaces that are substantially parallel to each other; a first drive unit coupled to the jaws and the base configured to reciprocally drive the jaws toward and away from each other; and a second drive unit coupled to the jaws, the first drive unit and the second drive unit configured to convey the jaws in either direction substantially parallel to the contact surfaces.

As a fourth aspect, embodiments of the present invention are directed to a bin for receiving, storing and dispensing a pharmaceutical dose package, comprising a box having first and second opposed, generally parallel side walls spanned by a floor and a rear wall. The front end of the box is open, and the first side wall includes an open-ended slot.

As a fifth aspect, embodiments of the present invention are directed to a carousel assembly, comprising: first and second sprockets; an endless member having a radially inward surface that engages the first and second sprockets, the endless member defining a generally oblong path; and a plurality of support members attached to the radially inward surface of the endless member and extending generally perpendicular to a plane defined by the oblong path. The first sprocket has a plurality of perimeter pockets, the perimeter pockets being sized and configured to receive the support members as they travel along the oblong path.

BRIEF DESCRIPTION OF THE FIGURES

<figref idref="DRAWINGS">FIG. 1</figref> is a perspective view of an automated pharmacy system according to embodiments of the present invention.

<figref idref="DRAWINGS">FIG. 2</figref> is a perspective view of the system of <figref idref="DRAWINGS">FIG. 1</figref> with the door shown in an open position for loading of prescriptions.

<figref idref="DRAWINGS">FIG. 3</figref> is a top perspective view of carousels of the system of <figref idref="DRAWINGS">FIG. 1</figref>.

<figref idref="DRAWINGS">FIG. 4</figref> is an enlarged front perspective view of a prescription being dispensed into the dispensing chute of the system of <figref idref="DRAWINGS">FIG. 1</figref>.

<figref idref="DRAWINGS">FIG. 5</figref> is a side perspective view of the carousels and dispensing chute of the system of <figref idref="DRAWINGS">FIG. 1</figref> with the door shown in an open position.

<figref idref="DRAWINGS">FIG. 6</figref> is an enlarged perspective view of an automated pharmacy system according to alternative embodiments of the present invention, with the door removed for clarity, showing a prescription dropping down the dispensing chute.

<figref idref="DRAWINGS">FIG. 7</figref> is perspective view of the system of <figref idref="DRAWINGS">FIG. 6</figref>.

<figref idref="DRAWINGS">FIG. 8</figref> is a front perspective view of an automated pharmacy system according to further embodiments of the present invention.

<figref idref="DRAWINGS">FIG. 9</figref> is a front perspective view of an automated pharmacy system according to still further embodiments of the present invention.

<figref idref="DRAWINGS">FIG. 10</figref> is a front perspective view of the system of <figref idref="DRAWINGS">FIG. 10</figref>, shown with the door in an open position.

<figref idref="DRAWINGS">FIG. 11</figref> is a front perspective view of an automated pharmacy system according to additional embodiments of the present invention.

<figref idref="DRAWINGS">FIG. 11A</figref> is an enlarged perspective view of the system of <figref idref="DRAWINGS">FIG. 11</figref> showing the small and large dispensing windows.

<figref idref="DRAWINGS">FIG. 12A</figref> is a perspective view of a small bin used in the system of <figref idref="DRAWINGS">FIG. 11</figref>.

<figref idref="DRAWINGS">FIG. 12B</figref> is a perspective view of a large bin used in the system of <figref idref="DRAWINGS">FIG. 11</figref>.

<figref idref="DRAWINGS">FIG. 12C</figref> is a perspective view of the small bin of <figref idref="DRAWINGS">FIG. 12A</figref> holding a “blister-pack” pharmaceutical package.

<figref idref="DRAWINGS">FIG. 12D</figref> is a perspective view of the small bin of <figref idref="DRAWINGS">FIG. 12A</figref> holding a single dose pharmaceutical package.

<figref idref="DRAWINGS">FIG. 13</figref> is a perspective view of the system of <figref idref="DRAWINGS">FIG. 11</figref> with the front and side wall removed.

<figref idref="DRAWINGS">FIG. 14</figref> is a rear perspective view of the carousel assembly and one shelf unit of the system of <figref idref="DRAWINGS">FIG. 11</figref>.

<figref idref="DRAWINGS">FIG. 15</figref> is a rear perspective view of the carousel assembly and one shelf unit of the system of <figref idref="DRAWINGS">FIG. 11</figref> showing the movement of the shelf unit from its position in <figref idref="DRAWINGS">FIG. 14</figref>.

<figref idref="DRAWINGS">FIG. 16</figref> is an enlarged partial rear perspective view of the carousel assembly of the system of <figref idref="DRAWINGS">FIG. 11</figref>.

<figref idref="DRAWINGS">FIG. 17</figref> is an enlarged partial bottom perspective view of the carousel assembly of the system of <figref idref="DRAWINGS">FIG. 11</figref>.

<figref idref="DRAWINGS">FIG. 18</figref> is an enlarged partial top perspective view of the carousel assembly of the system of <figref idref="DRAWINGS">FIG. 11</figref>.

<figref idref="DRAWINGS">FIG. 19A</figref> is a perspective view of a lower sprocket of the carousel assembly of <figref idref="DRAWINGS">FIG. 14</figref>.

<figref idref="DRAWINGS">FIG. 19B</figref> is a perspective view of the lower sprocket of <figref idref="DRAWINGS">FIG. 19A</figref> engaged by the lower belt and rods attached thereto.

<figref idref="DRAWINGS">FIG. 20A</figref> is a perspective view of a shelf unit of the system of <figref idref="DRAWINGS">FIG. 11</figref>.

<figref idref="DRAWINGS">FIG. 20B</figref> is an enlarged perspective view of a single shelf of the shelf unit of <figref idref="DRAWINGS">FIG. 20A</figref>.

<figref idref="DRAWINGS">FIG. 21A</figref> is a front perspective view of the carrier assembly of the system of <figref idref="DRAWINGS">FIG. 11</figref>.

<figref idref="DRAWINGS">FIG. 21B</figref> is a rear perspective view of the carrier assembly of <figref idref="DRAWINGS">FIG. 21A</figref>.

<figref idref="DRAWINGS">FIG. 22</figref> is a rear view of the drive and passive rollers for the small and large dispensing windows of the system of <figref idref="DRAWINGS">FIG. 11</figref>.

<figref idref="DRAWINGS">FIGS. 23A-23L</figref> are sequential views showing the transfer of a small bin from a shelf unit to the small dispensing window.

DETAILED DESCRIPTION OF EMBODIMENTS OF THE INVENTION

The present invention will now be described more fully hereinafter, in which preferred embodiments of the invention are shown. This invention may, however, be embodied in different forms and should not be construed as limited to the embodiments set forth herein. Rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey the scope of the invention to those skilled in the art. In the drawings, like numbers refer to like elements throughout. Thicknesses and dimensions of some components may be exaggerated for clarity.

Unless otherwise defined, all terms (including technical and scientific terms) used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. It will be further understood that terms, such as those defined in commonly used dictionaries, should be interpreted as having a meaning that is consistent with their meaning in the context of the relevant art and will not be interpreted in an idealized or overly formal sense unless expressly so defined herein.

The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. As used herein, the singular forms “a”, “an” and “the” are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms “comprises” and/or “comprising,” when used in this specification, specify the presence of stated features, integers, steps, operations, elements, and/or components, but do not preclude the presence or addition of one or more other features, integers, steps, operations, elements, components, and/or groups thereof. As used herein the expression “and/or” includes any and all combinations of one or more of the associated listed items.

In addition, spatially relative terms, such as “under”, “below”, “lower”, “over”, “upper” and the like, may be used herein for ease of description to describe one element or feature's relationship to another element(s) or feature(s) as illustrated in the figures. It will be understood that the spatially relative terms are intended to encompass different orientations of the device in use or operation in addition to the orientation depicted in the figures. For example, if the device in the figures is turned over, elements described as “under” or “beneath” other elements or features would then be oriented “over” the other elements or features. Thus, the exemplary term “under” can encompass both an orientation of over and under. The device may be otherwise oriented (rotated 90 degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly.

Well-known functions or constructions may not be described in detail for brevity and/or clarity.

The proposed system utilizes a unit dose storage system that allows any medication to be stored in any location of the unit. Unit doses may be prepared in any number of ways; exemplary methods are disclosed in, for example, U.S. Pat. Nos. 6,449,921; 6,585,132; and 7,428,805, the disclosures of which are hereby incorporated herein. An exemplary unit dose package <b>310</b> is shown in connection with an automated pharmacy system <b>300</b> in <figref idref="DRAWINGS">FIG. 8</figref>, although the package <b>310</b> may take different forms such as a blister pack, strip pack, box, bag, vial, IV solution bag, ampoule, etc. The proposed system utilizes bar code reading technology (i.e., a bar code scanner to read the bar code <b>311</b> on the package <b>310</b>); however, future embodiments could include other identification technology, such as RFID, to provide confirmation of the identity of the product and/or to associate a specific product to a specific location within the unit after the product has been loaded into the device.

Although the product may be scanned to read the affixed code prior to placement in the specific location, in some embodiments the association of a product to a location only occurs after the product has been loaded into an unoccupied product storage location within the system. Even when the items are scanned prior to placement in a location, the system may still scan each location to ensure that the product was properly placed in the system. Either during loading of an individual product or immediately after a variety of products are loaded in bulk into the system, the system's bar code verification process validates which products are stored in which location by scanning each location. Each system storage location contains only one unique product, although the quantity of that product can vary. Each product packet may hold one or more pills of a given medication, and the system may include different packets having different numbers of pills of the same medication to facilitate different dosing options (e.g., there may be separate packets with one, two, three or four pills of 200 mg ibuprofen to facilitate administration of 200 mg, 400 mg, 600 mg, or 800 mg doses of the medication, depending on a doctor's orders).

<figref idref="DRAWINGS">FIGS. 1-5</figref> illustrate an automated pharmacy system <b>100</b> in which products are stored on a series of rotating horizontal carousels that utilize storage clips/slots/bins to securely hold individual products. The overall system <b>100</b> is illustrated in <figref idref="DRAWINGS">FIG. 1</figref> with its front door closed and in <figref idref="DRAWINGS">FIG. 2</figref> with the front door open. Each storage location in the system <b>100</b> has a unique location ID in the system. Once a product is loaded, or when the product is scanned while loading the product into the system <b>100</b>, and/or upon a scanning confirmation of product placement after loading, the system creates an association between the location and the product. Loaded products <b>310</b> are shown in <figref idref="DRAWINGS">FIG. 3</figref>. In some embodiments, the system is loaded with products by opening the door of the unit, as shown in <figref idref="DRAWINGS">FIG. 2</figref>, and products are placed in available and/or designated locations.

Alternatively, as shown in <figref idref="DRAWINGS">FIG. 8</figref>, the system <b>300</b> may utilize slots <b>302</b>A-D, <b>303</b> and <b>304</b> to allow loading of product into the unit without opening the door to expose the entire contents of the system. In the system <b>300</b>, the slots <b>302</b>A-D, <b>303</b> and <b>304</b> may be covered by a single door or individual doors. Upon a request to load a package of a particular size into the system, a controller sends a command to open the appropriately sized slot corresponding to the physical storage level in which a storage location is available. The product to be added to the inventory is then inserted into the accessible slot <b>302</b>A-D, <b>303</b> or <b>304</b>. For example, in a system where a door or doors cover the slots <b>302</b>A-D, <b>303</b> or <b>304</b>, upon a request to add a small package, such as an individual medication package <b>310</b>, to the inventory of the system, the controller sends a command to open the door associated with slot <b>302</b>A when an available storage location is located on the uppermost level of the unit. The package is inserted into the slot <b>302</b>A by the user, and rollers or another transport mechanism convey the package to the interior of the unit. The rollers may be made of flexible material so as to not damage the package or its contents. Scanners may be co-located with the slots <b>302</b>A-D, <b>303</b>, <b>304</b> so that the barcode or other identifying indicia on the package <b>310</b> is scanned as the package is entering through the slot. In some embodiments the scanners may be associated with the inside edge of the slot so that the bar code <b>311</b> is read after the package is retained inside the unit to protect the system from deliberate or unintentional entry of a package different from the scanned package. The package <b>310</b> may be loaded directly into the storage bin or holding clip (see <figref idref="DRAWINGS">FIG. 4</figref> and accompanying discussion, infra) as it enters through the slot or it may be captured by a robotic arm that then transports the package <b>310</b> from the slot to the available storage location. If available storage locations for a small package are instead located on the second level of the unit, the door to slot <b>302</b>B opens and the same process is followed. If the package to be loaded is of a larger size, appropriate for storage locations associated with slot <b>303</b> or <b>304</b>, then the door associated with the appropriate slot is opened and the product is loaded as discussed. In other embodiments, one or more loading slots may be provided in other locations not associated with the separate storage levels, for example at the bottom on the unit, where all product <b>310</b> to be loaded into the unit is introduced via rollers, as described above, and retrieved by a robotic arm for placement in a storage location anywhere within the unit. A single slot or door may be provided for loading of products <b>310</b> of all sizes, or slots/doors of various sizes may be provided in the same general vicinity to accommodate loading of products of different size classes.

In some embodiments of the invention, the system may accept totes or other containers capable of large capacity storage; such totes would contain some or all of the inventory to be loaded into the system. Once the tote is deposited inside the unit (via a door or other access method), a robotic arm (i.e., actuator and end effector) inside the unit may remove individual packages from the tote or loading area and place each package in an available storage location within the unit. The robotic arm may include a bar code scanner to automatically scan the indicia on the package prior to placing the package in a storage location. Alternatively, the robotic arm may first move the package to a scanner for scanning prior to placing the package in the storage location.

Upon receipt of a dispense request, the system determines the location of the user selected products and dispenses them by rotating the carousel/bins containing the products to a delivery chute (see <figref idref="DRAWINGS">FIG. 4</figref>). In some embodiments of the invention, such as that exemplified in <figref idref="DRAWINGS">FIG. 4</figref>, each product <b>310</b> is held by a clip in its respective location. Upon a dispense request from the controller, the requested product <b>310</b> is moved (i.e., by a telescoping action of a rod attached to the clip) to a position above a delivery chute <b>110</b> and the product is released from the clip into the delivery chute <b>110</b> (i.e., prongs of the clip are separated to release the package). In other embodiments, such as the system <b>200</b> shown in <figref idref="DRAWINGS">FIGS. 6 and 7</figref>, each location may include an appropriately sized bin <b>205</b> that holds the product <b>310</b> in its location. In such embodiments, upon a dispense request from the controller, the bin <b>205</b> is tilted so as to empty its contents into the delivery chute <b>210</b>.

Once the products are released from the carousel/bin, they descend down the delivery chute to the user pick-up slot (the pick-up slot <b>101</b> can be seen in <figref idref="DRAWINGS">FIG. 5</figref> mounted to the inside of the access door and on the outside of the unit <b>100</b> in <figref idref="DRAWINGS">FIG. 1</figref> and the pick-up slot <b>301</b> can be seen on the outside of the unit <b>300</b> in <figref idref="DRAWINGS">FIG. 8</figref>). The various levels of the system can function independently such that multiple products can be dropped simultaneously from the different carousels down the delivery chute to the user pick-up slot <b>101</b>, <b>301</b> or they may be dropped sequentially to allow the user to retrieve them from the pick-up slot <b>101</b>, <b>301</b> simultaneously. The user has access to the products once they have landed in the user pick-up slot. The access door to the pick-up slot may be locked to prevent unauthorized access to medications that have been dispensed (see discussion below regarding security and user authorization). In some embodiments, the system includes refrigeration for one or more levels of storage locations. Such refrigerated units may be used to store medications such as, for example, insulin, certain antibiotics, or other medications that require storage at temperatures lower than ambient temperature.

Users access the system <b>100</b> via a touch screen <b>102</b> (shown in <figref idref="DRAWINGS">FIG. 1</figref>), which interfaces with software and a controller which validates a user's credentials against a database to ensure only those individuals who have been authorized to utilize the system can access products contained within the unit or to run any form or reporting on the system. In some embodiments of the invention, all users must have the proper credentials to access the system and, once validated, may dispense any of the medications from the system. In other embodiments, once validated as an authorized user of the system, some users may be permitted to dispense only a portion of the types of medications in the system due to security considerations (i.e., some users may be allowed to access all types of medications except narcotics). In some embodiments, users may be required to confirm their identity (i.e., enter an authorization code, scan an identification badge, or satisfy an RFID or biometric-based security check) and have their level of authorization confirmed by the system prior to the controller signaling release of the lock on the access door to the pick-up slot in order to allow access to the dispensed medication). All user access and activity, can be stored on the system via data base entries, biometric logs and digital photography.

User interaction with the touch screen <b>102</b> also may include selection of the medication to be dispensed, selection of the patient for whom the medication is being dispensed, requests for various types of reports (see below), restocking requests, inventory analysis, etc.

In some embodiments of the invention, various types of records are maintained by the system and reports of such records may be created by the system. Records may include information regarding which users accessed the system and the date and time of the access, which medications were dispensed, which medications were dispensed by each user, the patient for whom each medication was dispensed, etc. Such reports may be created upon request or the system may be programmed to create certain reports automatically (e.g., at the end of a shift, when a patient is discharged or moved from the facility, etc.).

In some embodiments, the system may include a camera (not shown) on the outside of the unit to capture the image of a user when accessing the system. Each picture taken by the camera may be stored in the system and matched against a particular activity such as replenishment of the unit on a specific day at a specific time and with respect to particular items that were stocked in the unit at that time, or a dispensing event of a particular medication or other item for a specific patient. The images may be included in the reports created by the system, as discussed above.

The system may be connected to the supplying pharmacy's pharmacy management system (e.g., its computer system) and may automatically communicate with information stored in the pharmacy management system. Such communications may include information regarding which medications have been dispensed from the system and, therefore, need to be restocked, confirmation that a medication that a user has requested for a particular patient has been approved for administration to that patient, etc. Other embodiments may include a two-way video and/or audio link with the pharmacy to facilitate approval for the removal of certain drugs (narcotics for example) from the unit regardless of patient drug regimens. Through such a link, a system user may request a drug that has not yet been approved for administration to a particular patient and provide the information necessary for review by the pharmacist (change in doctor's order, reason for request for administration to that patient, etc.). The pharmacist may then perform appropriate reviews (drug interactions, insurance adjudication, etc.) and either approve or disapprove the dispensing of the drug from the system for the specified patient.

The system may be connected to a scanner that can be used in the administration of the medication to the Patient. Such a scanner may be a wireless portable scanner or may be located in the patient rooms (“bedside scanners”). A bedside scanner may be configured as assigned to a particular patient or either the portable or the bedside scanner may be used to scan a code on the patient's wristband or other form of identification to identify the patient. When the dispensed medication is administered to the patient, the portable or bedside scanner may additionally be used to scan the indicia on the medication package to confirm that the correct medication is being given to the correct patient. Such codes on the package or associated with the patient may be barcode, RFID or other appropriate technology. Via software and a wireless or Ethernet-based connection, the scanner may then communicate with the system to record the administration of the medication to the patient. Additionally, the scanner may be able to be docked on or near the unit to recharge the scanner and/or download information.

Various security features may be included with the system. The unit may be bolted to the floor or wall and may include security doors that are able to withstand attempts at forced entry and are self locking upon manual closure. The system may include an alarm system that is triggered by any movement of the unit, forced entry or other manipulation, power failure after manipulation, etc. In some embodiments, the system may include a sensor to detect if the door is opened. The system may be configured to sound an alarm when the door is opened without proper authorization or if the door remains open for an extended time period. Additionally, the unit may include an internal camera to capture images when the system is opened. The camera may be adapted to run off battery power so that it is able to function even when power is not supplied to the unit as a whole. The alarm system may be tied into facility security and may have the ability to contact local authorities. The alarm system may operate independently of the facility power source and may be able to maintain or bypass internet connectivity if that can also be compromised. A camera on the unit may be activated for image capture if the alarm is triggered.

In some embodiments, the system may include temperature, humidity, and/or other environmental sensors to monitor environmental conditions within the cabinet to ensure proper storage conditions of the items. The sensor may interface to an external monitor or other display so that the temperature/humidity conditions can be evaluated from outside the unit. The environmental sensor(s) may work in conjunction with an alarm system to notify users when environmental conditions within the cabinet are not within acceptable ranges.

The unit may be enabled for user authorization via biometric scanning (i e, fingerprint, palm print, retinal scan, voice recognition, facial recognition, etc.). Unit security features may also or alternatively include a requirement for scanning of a user badge or entry of a code. User authorization may be performed prior to dispensing or restocking of the unit and authentication information recorded and stored by the unit.

Another embodiment of the present invention is illustrated in <figref idref="DRAWINGS">FIGS. 9 and 10</figref>. The system <b>400</b> shown therein utilizes vertically-oriented carousels <b>402</b> that contain products within compartments <b>403</b> that rotate with the carousel. A horizontal row of access doors <b>401</b> is located in the front of the cabinet door. Each access door is aligned with one of the carousels <b>402</b> and opens when the compartment <b>403</b> containing the desired product is rotated into position just rearward of the access door <b>401</b>. A similar arrangement is shown in U.S. Pat. No. 7,228,200 to Baker, the disclosure of which is hereby incorporated herein in its entirety.

The embodiments described herein may also be applicable in a traditional hospital setting where the administration of medication to patients is overseen by hospital staff and may need to occur on an as-needed basis. By providing access to such a system on hospital floors or in hospital emergency rooms (as well as urgent care centers), access to medications can be provided even when access directly to the pharmacy itself is not feasible.

Another system according to embodiments of the present invention is shown in <figref idref="DRAWINGS">FIGS. 11-23L</figref> and designated broadly at <b>500</b>. As can be seen in <figref idref="DRAWINGS">FIGS. 11 and 11A</figref>, the system <b>500</b> includes a housing <b>502</b> having a front wall <b>504</b> and side walls <b>506</b><i>a</i>, <b>506</b><i>b </i>that define an internal cavity. A small dispensing window <b>510</b> is present in the front wall <b>504</b>, as is a large dispensing window <b>512</b> below the small dispensing window <b>510</b>. A display screen <b>514</b> is located on the front wall <b>504</b> to receive input from a user and to display information about the system <b>500</b>; the display screen <b>514</b> is connected with a controller (not visible in <figref idref="DRAWINGS">FIG. 11</figref>) that controls operation of the system <b>500</b>. A bar code scanner <b>516</b> is also mounted to the front wall <b>504</b>.

Referring to <figref idref="DRAWINGS">FIG. 11A</figref>, the small dispensing window <b>510</b> includes a rectangular frame <b>511</b> having an attached horizontal stage <b>511</b><i>a </i>that projects forwardly away from the front wall <b>504</b>. As can be seen in <figref idref="DRAWINGS">FIG. 11A</figref>, the stage <b>511</b><i>a </i>has an upraised rim <b>511</b><i>b </i>about its periphery to capture and retain a small bin <b>570</b> (discussed in greater detail below) on the stage <b>511</b><i>a</i>. Similarly, the large dispensing window <b>512</b> has a frame <b>513</b> and a stage <b>513</b><i>a </i>that projects forwardly away from the front wall <b>504</b>; a rim <b>513</b><i>b </i>is located on the periphery of the stage <b>513</b><i>a </i>to capture and retain a large bin <b>578</b> (also discussed in greater detail below). Either or both of the small and large dispensing windows <b>510</b>, <b>512</b> may have a door (e.g., a sliding plate—this is not shown herein) that covers the window <b>510</b>, <b>512</b> when the system <b>500</b> is inactive.

Turning now to <figref idref="DRAWINGS">FIG. 12A</figref>, a small bin <b>570</b> is a truncated box with two side walls <b>572</b>, <b>574</b> and a floor <b>573</b>. As can be seen in <figref idref="DRAWINGS">FIG. 12A</figref>, the side wall <b>572</b> includes a slot <b>576</b> that extends from the front edge of the side wall <b>572</b> toward the rear of the small bin <b>570</b>. The slot <b>576</b> is lined with a curved flange <b>577</b> that extends into the small bin <b>570</b> to form a narrow gap <b>570</b><i>a</i>, and flares open slightly at its open end. The floor <b>573</b> of the small bin <b>570</b> includes a recess <b>573</b><i>a. </i>

As can be seen in <figref idref="DRAWINGS">FIG. 12C</figref>, the small bin <b>570</b> is sized to hold a single dose “blister pack” BP of a pharmaceutical (with the upstanding “blister” residing in the slot <b>576</b>). The small bin <b>570</b> is also sized to hold a conventional single dose of a pharmaceutical P (see <figref idref="DRAWINGS">FIG. 12D</figref>). The gap <b>570</b><i>a </i>is sufficiently narrow that it tends to retain the packaging in the bin <b>570</b> so that the packaging does not fall out of the bin <b>570</b>; the oblique angle of the slot <b>576</b> relative to the bin floor can also help to retain the packaging. Also, the narrow space between the side walls <b>572</b>, <b>574</b> urges the package to remain generally vertical, which enables a bar code positioned on the side of the packaging to be in a predictable location and therefore to be readable to a bar code scanner <b>550</b><i>a</i>, <b>550</b><i>b </i>located on a carrier assembly <b>530</b> (described below), particularly if the bin <b>570</b> is formed of a transparent material.

Referring to <figref idref="DRAWINGS">FIG. 12B</figref>, the large bin <b>578</b> includes is a box with side walls <b>578</b><i>a</i>, <b>578</b><i>b </i>that are spanned by a floor <b>579</b> and a ceiling <b>581</b>. The floor <b>579</b> includes three slots <b>579</b><i>a</i>; the ceiling includes three slots <b>581</b><i>a</i>. The side walls <b>578</b><i>a</i>, <b>578</b><i>b </i>are separated by a width that is substantially equal to the width of four small bins <b>570</b>. A “half” front wall helps to retain pharmaceutical packages within the large bin <b>578</b>.

Referring now to <figref idref="DRAWINGS">FIG. 13</figref>, the system <b>500</b> includes a frame <b>520</b> comprising upright support posts <b>522</b>, a ceiling <b>526</b> and a floor <b>524</b>. A carousel assembly <b>580</b> (best seen in <figref idref="DRAWINGS">FIGS. 14-20</figref>) is mounted to the frame <b>520</b>. The carousel assembly <b>580</b> includes an endless chain of generally vertically-disposed shelf units <b>560</b> that revolve in an oblong path driven by a carousel drive assembly <b>700</b>. These components are described in greater detail below.

Referring now to <figref idref="DRAWINGS">FIG. 14</figref>, the carousel drive assembly <b>700</b> includes two sprocket units <b>701</b><i>a</i>, <b>701</b><i>b</i>, each of which has upper and lower sprockets <b>702</b><i>a</i>, <b>702</b><i>b </i>attached to a common vertical axle <b>704</b>. The lower sprockets <b>702</b><i>b </i>are rotatably mounted in the floor <b>524</b> for rotation about respective vertical axes of rotation. Similarly, the upper sprockets <b>702</b><i>a </i>are rotatably mounted in the ceiling <b>526</b>. The lower sprockets <b>702</b><i>b </i>include four perimeter pockets <b>703</b> (best seen in <figref idref="DRAWINGS">FIGS. 19A and 19B</figref>), and the upper sprockets <b>702</b><i>a </i>include four perimeter pockets <b>705</b>. A lower belt <b>706</b> engages the lower sprockets <b>702</b><i>b</i>, and an upper belt <b>708</b> engages the upper sprockets <b>702</b><i>a. </i>

Vertical rods <b>710</b> are mounted to the radially inward surfaces of the upper and lower belts <b>708</b>, <b>706</b> spaced apart several inches from each other. Referring to <figref idref="DRAWINGS">FIGS. 16 and 19B</figref>, at its lower end, each rod <b>710</b> attaches to a ridged wheel <b>712</b> below the lower belt <b>708</b>. The wheels <b>712</b> are at a height such that the ridges of the wheels <b>712</b> can capture either of two parallel rails <b>714</b> that are mounted to the floor <b>524</b> to be generally tangential to the circumference of the lower sprockets <b>702</b><i>b</i>. A round bearing <b>713</b> is fixed to each rod <b>710</b> just above the lower belt <b>708</b>. At its upper end, each rod <b>710</b> includes three horizontally disposed wheels <b>716</b> that are positioned to capture parallel rails <b>718</b> mounted on the underside of the ceiling <b>526</b> (see <figref idref="DRAWINGS">FIGS. 17 and 18</figref>), with two wheel <b>716</b> on the “inside” of the rail <b>718</b> and one wheel <b>716</b> on the “outside” of the rail <b>718</b>.

On the lower side of the ceiling <b>526</b>, a motor <b>720</b> is mounted between the upper sprockets <b>702</b><i>a</i>. The shaft of the motor <b>720</b> extends through the ceiling <b>526</b> and attaches to a small drive pulley <b>722</b> (<figref idref="DRAWINGS">FIG. 18</figref>). A large pulley <b>724</b> is mounted above the ceiling <b>526</b> to and coaxially with one of the upper sprockets <b>702</b><i>a</i>. A drive belt <b>726</b> engages both the drive pulley <b>722</b> and the large pulley <b>724</b>. The motor <b>720</b> is connected with the controller.

Referring now to <figref idref="DRAWINGS">FIGS. 20A and 20B</figref>, each shelf unit <b>560</b> includes a rear panel <b>561</b> mounted to a respective support member in the form of a rod <b>710</b>. A number of shelves <b>562</b> are mounted to each rear panel <b>561</b>. Each shelf <b>562</b> has a number of raised and depending ribs <b>563</b> that divide the shelf <b>562</b>. The ribs <b>563</b> are spaced such that a small bin <b>570</b> can nest between an adjacent pair of ribs <b>563</b> (see <figref idref="DRAWINGS">FIG. 20B</figref>), and such that a large bin <b>578</b> can fit between ribs <b>563</b> with three consecutive ribs <b>563</b> located therebetween, with the consecutive ribs <b>563</b> being received in the slots <b>579</b><i>a </i>of the large bin <b>578</b> (shown in <figref idref="DRAWINGS">FIG. 12B</figref>). Thus, for small bins <b>570</b> a storage location is defined between each set of adjacent ribs <b>563</b>, and for large bins <b>580</b> a storage location is defined between ribs <b>563</b> separated by three consecutive ribs <b>563</b>. Also, each shelf <b>562</b> includes a transverse ridge <b>564</b> that is received in the recess <b>576</b> of the small bin <b>570</b> or the recess <b>579</b><i>c </i>of the large bin <b>578</b>. The transverse ridge <b>564</b> helps to maintain a small or large bin <b>570</b>, <b>578</b> in place on the shelf <b>562</b> in a passive retaining system.

The carousel assembly <b>700</b> can revolve the shelf units <b>560</b> about an oblong path defined generally by the upper and lower belts <b>708</b>, <b>706</b>. When the shelf units <b>560</b> are to revolve, the controller signals the motor <b>720</b>, which rotates the drive pulley <b>722</b>. Rotation of the drive pulley <b>722</b> rotates the large pulley <b>724</b> via the drive belt <b>726</b>. Because the drive pulley <b>724</b> is fixed to one of the upper sprockets <b>702</b><i>a</i>, rotation of the drive pulley <b>724</b> rotates that upper sprocket <b>702</b><i>a </i>and the remainder of the sprocket unit <b>701</b><i>a</i>. Rotation of the upper and lower sprockets <b>702</b><i>a</i>, <b>702</b><i>b </i>of the sprocket unit <b>701</b><i>a </i>causes the sprocket unit <b>701</b><i>b </i>to rotate also via the upper and lower belts <b>708</b>, <b>706</b>. Rotation of the sprocket units <b>701</b><i>a</i>, <b>701</b><i>b </i>drives the shelf units <b>560</b> around the oblong path noted above (see <figref idref="DRAWINGS">FIGS. 14 and 15</figref>).

As the shelf units <b>560</b> revolve, they are maintained on the oblong path via multiple interactions with other components. The wheels <b>716</b> capture the rails <b>718</b> on the ceiling <b>526</b> as the shelf units <b>560</b> travel along the straight portions of the oblong path to maintain the shelf units <b>560</b> in position on the path (see <figref idref="DRAWINGS">FIG. 17</figref>). The ridged wheels <b>712</b> ride upon the rails <b>714</b> on the floor <b>524</b> as the shelf units <b>560</b> travel along the path to maintain the vertical position of the shelf units <b>560</b> (see <figref idref="DRAWINGS">FIG. 16</figref>). As the shelf units <b>560</b> travel on the arcuate portions of the path, the rods <b>710</b> fit within the perimeter pockets <b>703</b> of the sprockets <b>702</b><i>a</i>, <b>702</b><i>b</i>, and the vertical position of the shelf units <b>560</b> is maintained by the interaction between the round bearings <b>713</b> and the surface of the lower sprockets <b>702</b><i>b </i>just above the pockets <b>703</b> (see <figref idref="DRAWINGS">FIG. 19B</figref>).

A robotic carrier unit <b>530</b> is slidably mounted via conventional construction to a vertical rail <b>531</b> located near the front of the frame <b>520</b> via a slide member <b>532</b>. A base in the form of a housing <b>533</b> is mounted to the slide member <b>532</b> and includes a floor <b>533</b><i>a </i>and a ceiling <b>533</b><i>b</i>. Mounting blocks <b>534</b> are mounted to the front and rear edges of the floor <b>533</b><i>a </i>and are spanned by two slide rods <b>535</b>. A carriage <b>536</b> is slidably mounted on the slide rods <b>535</b> for slidable movement thereon, driven by a motor <b>537</b> and a rack-and-pinion arrangement (not shown). The carriage <b>536</b> includes two upwardly-extending flanges <b>538</b> on which are mounted two slide rods <b>539</b>. A lead screw <b>540</b> is mounted parallel to the slide rods <b>539</b> and extends through one of the flanges <b>538</b> to attached to a motor <b>541</b> mounted thereon. Two jaw blocks <b>542</b><i>a</i>, <b>542</b><i>b </i>are mounted on the slide rods <b>539</b> and the lead screw <b>540</b>. A jaw <b>544</b> is mounted on each jaw block <b>542</b><i>a</i>, <b>542</b><i>b </i>and extends upwardly therefrom through an opening <b>545</b> in the ceiling <b>533</b><i>b </i>of the housing <b>533</b> with contact surfaces <b>544</b><i>a </i>of the jaws <b>544</b> being parallel and facing each other. A bar code reader <b>550</b><i>a </i>is mounted on a pedestal attached to the side wall of the housing <b>533</b>, and an opposing bar code reader <b>550</b><i>b </i>is mounted on the opposite side wall of the housing <b>533</b>.

The robotic carrier unit <b>530</b> has the ability to open and close the jaws <b>544</b> and to move them forwardly and rearwardly relative to the housing <b>533</b>. Actuation of the motor <b>537</b> causes the rack-and-pinion mechanism to drive the carriage <b>536</b> along the slide rods <b>535</b>, which in turn moves the jaws <b>544</b> forwardly or rearwardly also. Actuation of the motor <b>541</b> turns the lead screw <b>540</b>, which in turn draws the jaws together or apart as desired. The controller can activate either of the motors <b>537</b>, <b>541</b> as needed.

Referring now to <figref idref="DRAWINGS">FIG. 22</figref>, a drive roller <b>600</b> is mounted on the rear side of the front wall <b>504</b> adjacent a side edge of the small dispensing window <b>510</b>, and a complimentary passive roller <b>602</b> is mounted opposite the drive roller <b>600</b>. The drive roller <b>600</b> is powered by a motor <b>604</b> controlled by the controller. Similarly, a drive roller <b>610</b> is mounted on the rear side of the front wall <b>504</b> adjacent a side edge of the large dispensing window <b>512</b>, and a complimentary passive roller <b>612</b> is mounted opposite the drive roller <b>610</b>. The drive roller <b>610</b> is powered by a motor <b>614</b> controlled by the controller.

To load the system <b>500</b> with single dose pharmaceutical package, a user activates the system <b>500</b> by inputting a loading command into the controller via the display screen <b>514</b>. The controller locates an empty bin (either a small bin <b>570</b> or a large bin <b>578</b>—for the purposes of this example, a small bin <b>570</b> will be discussed) on one of the shelves <b>562</b> of a shelf unit <b>560</b>. In some embodiments, the bins in the rows closest to the small and large windows <b>510</b>, <b>512</b> are kept empty whenever possible to facilitate rapid loading. If the small bin <b>570</b> selected by the controller (which could be any empty small bin <b>570</b>) is not aligned already with the jaws <b>544</b> of the carrier unit <b>530</b>, the controller signals the carousel drive assembly <b>700</b> to revolve the shelf units <b>560</b> until the selected bin <b>570</b> is aligned with and rearward of the jaws <b>544</b>.

Once the bin <b>570</b> is in place, the controller signals the carrier assembly <b>530</b> to move vertically on the rail <b>531</b> to the correct height to retrieve the bin <b>570</b>. As shown in <figref idref="DRAWINGS">FIG. 23A</figref>, the jaws <b>544</b> of the carrier assembly <b>530</b> separate and move horizontally toward the bin <b>570</b> until the rear ends of the jaws <b>544</b> are sufficiently rearward to grasp the front end of the bin <b>570</b>. The controller then signals the jaws <b>544</b> to close onto the bin <b>570</b> to grasp it. The motor <b>537</b> then draws the carriage <b>536</b> forward (to the right in <figref idref="DRAWINGS">FIG. 23B</figref>) as the jaws <b>544</b> grasp the bin <b>570</b>, thereby drawing the bin <b>570</b> forwardly and partially onto the upper surface of the ceiling <b>533</b><i>b</i>. The jaws <b>544</b> then separate and move rearwardly (driven by the motor <b>537</b> forcing the carriage <b>536</b> rearwardly) as the bin <b>570</b> rests on the ceiling <b>533</b><i>b </i>(<figref idref="DRAWINGS">FIG. 23C</figref>). The jaws <b>544</b> then close on the bin <b>570</b> again and move forwardly as before; in doing so, the jaws <b>544</b> “inchworm” the bin <b>570</b> forwardly (<figref idref="DRAWINGS">FIGS. 23D and 23E</figref>). These actions continue until the bin <b>570</b> activates a locating sensor on the jaws <b>544</b>. The carrier assembly <b>530</b> moves vertically on the rail <b>531</b> until it reaches a location that positions the bin <b>570</b> approximately level with the small window <b>510</b> (<figref idref="DRAWINGS">FIGS. 23F-23H</figref>).

Once in position adjacent the small window <b>510</b>, the door opens, the jaws <b>544</b> move forwardly, separate, move rearwardly, close on the small bin <b>570</b>, and move forwardly again (<figref idref="DRAWINGS">FIGS. 23I-23K</figref>). Repetition of this movement positions the bin <b>570</b> with its front edge adjacent the drive roller <b>600</b> and the passive roller <b>602</b>. The motor <b>604</b> rotates the drive roller <b>600</b>, which drives the bin <b>570</b> through the small dispensing window <b>510</b> and onto the stage <b>511</b> (<figref idref="DRAWINGS">FIG. 23L</figref>). The small bin <b>570</b> is captured within the small dispensing window <b>510</b> by the rim <b>511</b><i>b </i>of the stage <b>511</b><i>a</i>, which prevents the small bin <b>570</b> from being removed from the small dispensing window <b>510</b>. From this position, the empty small bin <b>570</b> can be loaded with a single dose pharmaceutical package or blister pack.

The operator may scan the package with the bar code scanner <b>516</b> prior to loading the package into the small bin <b>570</b>, or may place the package directly into the small bin <b>570</b>. As described above, the package is generally vertically disposed in the small bin <b>570</b>; if the package is a blister-pack, the “blister” resides in the slot <b>576</b> in the manner shown in <figref idref="DRAWINGS">FIG. 12C</figref>. In either event, the package is positioned therein such that a bar code affixed thereto is located below the slot <b>576</b> for reading by one of the bar code readers <b>550</b><i>a</i>, <b>550</b><i>b. </i>

After the small bin <b>570</b> is loaded with the pharmaceutical package, the controller signals the system <b>500</b> to reverse the steps described above in connection with the presentation of the small bin <b>570</b>. More specifically, the drive roller <b>600</b> rotates to draw the small bin <b>570</b> back through the small dispensing window <b>510</b> until locating sensors in the jaws <b>544</b> detect the presence of the small bin <b>570</b> in position between the jaws <b>544</b>. The jaws <b>544</b> close to grasp the bin <b>570</b> and move rearwardly to “inch” the package rearwardly. The jaws <b>544</b> then separate, move forwardly to center the jaws <b>544</b> on the bin <b>570</b>, and close to grasp the bin <b>570</b>. The carrier assembly <b>530</b> then moves vertically on the rail <b>531</b> to position the bin <b>570</b> at the proper height for loading onto the selected shelf <b>562</b>. Under most circumstances, the carrier assembly <b>530</b> will simply return the small bin <b>570</b> to the location on the shelf <b>562</b> that it just vacated prior to loading; however, another storage location may be selected, in which case the controller activates the carousel assembly <b>700</b> to rotate the shelf unit <b>560</b> having the selected shelf <b>562</b> to a position in line with the jaws <b>544</b>.

When the carrier assembly <b>530</b> and the shelf <b>562</b> are both in position, the controller signals the carrier assembly <b>530</b> to load the bin <b>570</b> into the selected storage location. The jaws <b>544</b> move rearwardly, separate, move forwardly, close onto the bin <b>570</b>, and move rearwardly with the bin <b>570</b>. This process is repeated until the carrier assembly locating sensors have been deactivated (with the bin <b>570</b> resting on either the ceiling <b>533</b><i>b </i>of the housing <b>533</b> or the shelf <b>562</b>, depending on how far rearwardly the bin <b>570</b> has moved) to “inch” the bin <b>570</b> into place in the selected location on the shelf <b>562</b>. The small bin <b>570</b> is retained in place by the interaction between the ridge <b>564</b> of the shelf and the recess <b>573</b><i>a </i>of the small bin <b>570</b>.

One additional step that may be performed during loading of the pharmaceutical package onto a storage location on a shelf <b>562</b> is reading of the bar code on the package by one of the bar code readers <b>550</b><i>a</i>, <b>550</b><i>b</i>. The bar code, which may be one- or two-dimensional, typically includes information about the pharmaceutical in the package, such as the NDC number, dosage or the like, that enables the system <b>500</b> to track the type of pharmaceutical being stored in a particular storage location.

To dispense a desired pharmaceutical, the controller simply identifies a storage location that contains the package of interest, then moves the carousel assembly <b>580</b> and the carrier assembly <b>530</b> as described above to move the bin <b>570</b> and carrier assembly <b>530</b> to a position in which the carrier assembly can retrieve the bin <b>570</b>. The carrier assembly <b>530</b> then moves the bin <b>570</b> to the dispensing window <b>510</b> in the manner described above in connection with <figref idref="DRAWINGS">FIGS. 23A-23L</figref>. In many instances, the bar code reader <b>550</b><i>a</i>, <b>550</b><i>b </i>will read the bar code on the package to confirm the identity of the pharmaceutical contained in the package. Once the small bin <b>570</b> and its package reach the small dispensing window <b>510</b>, the package can be removed from the bin <b>570</b>. The small bin <b>570</b> can then either be loaded with a different package or can be returned empty to its storage location.

A similar sequence of steps would be followed for the loading, storage, and dispensing of pharmaceutical items in a large bin <b>578</b>, with the exceptions that (a) the large bin <b>578</b> would be presented to and withdrawn from the large dispensing window <b>512</b>, and (b) in some cases the form of the package will not make it possible for the bar code scanner <b>550</b><i>a</i>, <b>550</b><i>b </i>to read the bar code on the package, so identification and confirmation of the package contents is typically performed at the bar code reader <b>516</b>.

The system <b>500</b> typically stores data associated with the storage and dispensing of pharmaceutical packages therein. As a result, the system <b>500</b> can provide reports (either on the display screen <b>514</b> or in hard-copy form) of inventory, dispensing, timing, and the like as described in some detail above in connection with the systems <b>100</b>, <b>300</b> and <b>400</b>.

Those skilled in this art will appreciate that the system <b>500</b> may take various other forms. For example, the motors and slide rods of the carrier assembly that control movement of the jaws <b>544</b> may be replaced with different varieties of drive units such as belt drives, conveyors, roller assemblies cam drives, and the like. Also, the rollers <b>600</b>, <b>602</b>, <b>610</b>, <b>612</b> may be omitted, or in some embodiments may be incorporated into the carrier assembly.

Some embodiments of the system may have only one dispensing window, or may have more than two dispensing windows. In single window embodiments, the window may be of a single permanent size, or may be configured to expand or contract between multiple sizes based on the size of the bin being used for storage or dispensing.

Similarly, the shelf units <b>560</b> may have only one size of shelf, or may have more than two sizes. Moreover, the shelf units may be deployed such that one or more shelf units includes shelves intended to house only one size of bin, and one or more other shelf units includes shelves intended to house only a different size of bin. Rather than the passive bin retaining system provided by the recesses in the bins and the ridges in the shelves, the shelf units may employ an active retaining system that includes springs, latches, magnets, doors, locks, clips or the like. In addition, the carousel assembly may be constructed differently, with sprockets that lack perimeter pockets (e.g., the rods may be mounted on the outer surface of the upper and lower belts), or with a path that is defined differently (including round). Other variations may also be suitable for use with the system.

Also, although blister-packs and pouches are shown herein as pharmaceutical dose packages, other forms of packaging may also be used, including envelopes, boxes, jars, vials, “bingo cards” (blister pack cards), and the like.

Those skilled in this art will also appreciate that features described above in connection with the systems <b>100</b>, <b>300</b> and <b>400</b>, such as refrigeration, security, and the like, may also be employed with the system <b>500</b>.

The foregoing embodiments are illustrative of the present invention, and are not to be construed as limiting thereof. Although exemplary embodiments of this invention have been described, those skilled in the art will readily appreciate that many modifications are possible in the exemplary embodiments without materially departing from the novel teachings and advantages of this invention. Accordingly, all such modifications are intended to be included within the scope of this invention.